Provider Demographics
NPI:1053739961
Name:SAKONA, ASHLYN
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:SAKONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-301-8732
Mailing Address - Fax:310-301-8751
Practice Address - Street 1:200 UCLA MEDICAL PLZ STE 365-C
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-2536
Practice Address - Country:US
Practice Address - Phone:310-206-7663
Practice Address - Fax:310-267-2571
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA148136207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program